Cirrhosis (Loss of Appetite and Malnutrition)

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Cirrhosis (hard, permanent scaring of the liver) is a late phase of fibrosis. Typically, it is a consequence of long-term damage caused by many types of liver disease. It can significantly affect the liver functions, leading to a number of serious problems such as appetite loss and malnutrition.

The disease usually starts from inflammation, which is also the starting point of many other liver diseases. The inflammation can be caused by several factors. The most common ones are injuries and infections. Many times the inflammation heals and doesn’t turn into serious. But sometimes it may continue over time, which then could be fatal if left untreated. The bad news, there is usually no any early signs and symptoms when your liver gets inflamed until it is extensive.

In time, the inflamed area may start to scar, causing scar tissues (also called fibrous tissues) to form. So though the liver is a tough organ that can repair itself when it gets injured, there is a chance for fibrous tissues to form every time when it tries to heal itself. The fibrous tissues can grow and replace healthy tissues — this phase is called fibrosis.

Fibrous tissues don’t work as well as healthy tissues of the liver. As they build up, the liver may still function like normal, but actually it doesn’t function as well as it once did. Because the healthy area of the liver needs to work harder to compensate for the scarred area!

Fibrosis is curable if treated soon enough. With appropriate treatment, the scared area may heal itself over time.

But the prognosis is worse if fibrosis turns into cirrhosis, when fibrous tissues become hard and permanent. Treatments for cirrhosis are usually focused to prevent the condition from worsening, stop (if possible) or slow the damage, and preserving the healthy tissues you have left.

In general, the damage caused by cirrhosis is irreversible which may require a liver transplant. But if it’s early diagnosed and the underlying cause is immediately treated, the liver function can be preserved and the damage, rarely, could also be reversed.

How does cirrhosis cause loss of appetite?

Left untreated cirrhosis will cause liver failure and other serious complications. Again early diagnosis and immediate treatment are necessary for better prognosis of the disease. Unfortunately, as with most types of liver disease, early damage caused by cirrhosis may not cause specific signs and symptoms until it becomes advanced. As the damage progresses, a number of symptoms occur – one of them could be loss of appetite.

As well we know that chemicals produced in the stomach and brain play a key role to control appetite. And it seems that the same goes for the liver. Some studies suggest that certain enzymes released by the liver may also affect appetite.

Even a liver enzyme called FBPase could be responsible for controlling appetite and weight gain, according to study published in 2012 edition of the journal Diabetes.

The way of how this liver enzyme works is not easy to understand. But some experts believe that it may have a role to stimulate several hormones in the brain that regulate appetite.

However, loss of appetite can also be attributed by many factors. So don’t take conclusion on your own, see your doctor for accurate diagnosis. If it’s really caused by cirrhosis, it’s usually followed with other symptoms of the disease, such as:

  1. Jaundice, yellowish skin and eyes.
  2. Intense itchy skin.
  3. Easy to bruise or bleed.
  4. Swelling due to fluid build ups in the abdomen or legs.
  5. More sensitive to side effects of medications.
  6. Impaired memory and difficulty concentrating, caused by toxin buildups in the brain.
  7. The disease may also cause unintentional weight loss, slurred speech, fatigue, red discoloration in the palms of hands, abnormal appearance of blood vessels (spiderlike) on the skin, and sometimes mental functioning problems.

Cirrhosis and malnutrition

Malnutrition is a condition in which your body doesn’t get the right amount of nutrients. It is common in patients with late stages of liver disease, including those with advanced cirrhosis.

The liver is responsible to filter blood, especially the blood coming from your digestive tract. It also plays a role to regulate hormones, store nutrients (such as fats, sugars, and vitamins), and releases nutrients when the body needs them.

So, it seems the liver function is very important to help support the digestive system and release vital nutrients (if necessary) for the body. And improper function of the liver can impair the body’s ability to process nutrients.

Loss of appetite caused by cirrhosis may make you unintentionally follow diet low in nutrients and calories, causing unintentional weight loss and even malnutrition. But loss of appetite is not to the only one to blame, because the disease can cause malnutrition in several ways.

  1. Other digestive discomforts caused by the disease — such as nausea, abdominal swelling, bloating, and abdominal pain –, may also have an effect.
  2. Portal hypertension, high blood pressure caused by increased pressure in the blood vessels that carry blood from nearby organs (the intestines and spleen) to the liver. This can impair digestion and nutrient absorption.
  3. Another reason is obstruction jaundice, also called ‘cholestatic liver disease’. It occurs when bile released by the liver is either blocked or reduced and retained in the circulation (bloodstream). Sometimes it causes decreased intraluminal bile salt (sodium) concentrations, which may impair the absorption of fat-soluble vitamins (A, D, E, and K).

Moreover certain medical conditions might coexist with cirrhosis, which some may also provoke malnutrition – for examples; pancreatic insufficiency, inflammatory bowel disease, infections (bacterial overgrowth), and mucosal congestion.


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